Bronze Plans

Bronze plans are one of four “metal” levels of coverage established by the Affordable Care Act. These plans can be very affordable depending on your anticipated medical needs.

When compared to the other three plans, Bronze plans typically have the lowest monthly insurance premiums. However, Bronze plans also tend to have the highest out-of-pocket costs and deductibles when using health insurance. Bronze will cover 60% of your health care costs, while you would be responsible for the remaining 40%, in addition to your monthly premium.

Example: You break your arm and need surgery, which costs $20,000. With a bronze plan, your insurance would pay $12,000 and you would be responsible for $6,850. This is because the annual maximum out-of-pocket limit for all ACA health plans is $6,850, even though the remaining balance is actually $8,000. This is in addition to your monthly premiums.

A Bronze plan could be the right choice if you:

  • Want the lowest monthly premium possible and do not qualify for a Catastrophic plan.
  • Anticipate rarely needing non-preventative medical services.
  • Foresee rarely taking prescription medication.
  • And do not mind paying more out-of-pocket in the event you need non-preventative medical care, including a sickness or major medical emergency.

As with all four plans, your monthly premium could be lowered greatly if you qualify for the Premium Tax Credit. The Premium Tax Credit is like a discount that is paid for by the government and applied to your monthly insurance rate. The main factor in determining your eligibility is your annual household income. Depending on the state you live in, your income must be at or below 4x the Federal Poverty Line to qualify for the Premium Tax Credit.

Remember that the only difference among plans is the amount you pay, not the quality of health care you receive. By law, all four plans must meet the Ten Essential Health Benefits, which includes a free wellness visit and preventative care.

Keep in mind that under Obamacare, all plans have the same maximum out-of-pocket limits no matter which metal level you choose. These limits protect you financially, especially if you need a lot of medical care. For 2016, the annual limit is $6,850 for an individual, and $13,700 for a family, including deductibles. Bronze plans pay for 60% percent of covered medical expenses before reaching the limit, and then 100% of all covered expenses after reaching the limit.

Even if you think a Bronze plan is right for you, you may also want to consider a Silver plan. If you qualify for the Premium Tax Credit, which lowers your monthly rate, you may also qualify for Cost-Sharing Reductions. Cost-Sharing Reductions are another type of discount on your out-of-pocket expenses that are paid for by the government. They are only available on Silver plans.

If you think you will need regular medical care, consider a Gold plan - especially if you do not qualify for Cost-Sharing Reductions. A Platinum plan could be an even better choice for those who need very frequent or major medical services.

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